Mighty Oaks Pain and Spine Clinic LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

MIGHTY OAKS PAIN AND SPINE CLINIC LLC

Practice address

14 Professional CT SW
Rome, GA 30165-2832

Phone

(706) 295-7333

NPI assigned

Dec 6, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anna Britman

Title

Credentialing

Phone

(770) 527-4489

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nazario Villasenor Jr., MD

  • Interventional Pain Medicine Physician
  • Cumming, GA
  • NPI 1326241563
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1003321407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PROFESSIONAL CT SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652832",
            "telephone_number": "706-295-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PROFESSIONAL CT SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652832",
            "telephone_number": "706-295-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGHTY OAKS PAIN AND SPINE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "BRITMAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "770-527-4489"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S. Jackson, MD, PC
• Dawne R Michael, MSN, AGPCNP-C
• Mitzie Marion Colet Mickelson, OTR/L, CPAM
• Brian Middleton, DPM
• Matthew David Middleton, PHARMD
• Veronica Miguel
• Peter Mikhail, MD
• Brandon Lloyd Miller, MD
• Christine Miller, PTA
• Jayden Claire Miller, MD

• Interventional Pain Medicine Physician in Rome, GA
• Providers in Rome, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.